Senior Q&A: Was Dad discharged too quickly?

Q: My father was discharged too quickly from the hospital and returned home with pneumonia. He was only home for a few days, and I brought him back to the hospital because he was coughing and having trouble breathing.

Q: My father was discharged too quickly from the hospital and returned home with pneumonia. He was only home for a few days, and I brought him back to the hospital because he was coughing and having trouble breathing.

I believe if the hospital kept my father a few more days, this would not have happened. Is there anything I can do to advocate for my father if this happens again?

A:Medicare has kept statistics of hospital admissions and hospital re-admissions. Recently, there have been a number of reports alleging hospitals have been too quick to discharge seniors.

There have been a high number of re-admissions, and it is difficult to assess how many of those re-admissions could have been avoided if the patients were kept in the hospital a few more days.

However, starting in 2013, hospitals will be financially penalized if a senior was initially admitted with pneumonia or certain cardiac illnesses and later re-admitted. Hospitals are in the process of improving discharge procedures to try to prevent as many re-admissions as possible.

If at any time you feel your father is being discharged too quickly, you have the right to go through a formal denial process and ask for a meeting with the staff to discuss your father, which is also the forum to discuss your father’s ability to manage at home. This is when the discussion needs to occur and to put plans in effect for your father to have a safe, smooth and easy transition back home with the necessary services.

Q:What is dementia? I hear the word Alzheimer’s and dementia. Are they all the same?

A: Dementia is a general term to describe memory loss. It is like saying “broken bone.” The broken bone can be the toe, the ankle, arm, etc. Dementia is a broad word.

It is important to then find out what type of dementia. Alzheimer’s is one type of dementia. There are more than 50 different types of dementia. If a family member has memory loss, talk with their physician or neurologist and ask specifically about what type of dementia the patient has.

The brain controls emotions, memories, the ability to process information, the ability to learn new information, speech, motor control, etc. Each part of the brain serves a purpose. If one part of the brain is not functioning properly, that is where the memory loss is most apparent.

This is why someone can speak well but not remember what they ate yesterday for lunch. The brain needs to work together, and when one part of the brain is not able to perform properly, it can cause memory loss.

Q: My parents have not shared their finances with their children. Who would be in charge if my parents cannot make decisions for themselves? Is there a list of topics I should discuss with them on my next visit?

Page 2 of 2 - A: This is not an easy discussion to have with your parents, but it is a very important one. Topics include health care proxy (who would your parents like to make medical decisions if they are unable to make medical decisions) and power of attorney (who can make financial decisions, write checks, etc. if they are unable to manage their finances).

It is also important to know their financial institutions, safety deposit box, financial advisors, life insurance, attorney, funeral home and burial requests. You should also discuss their opinion on end-of-life topics, such as being resuscitated, feeding tubes, life support, etc. If possible, discuss with them their opinions about services in the home, assisted living facilities and even nursing homes.

The more your parents share with you, the easier it will be to make medical and financial decisions on their behalf should you be in that position. There is a lot of information to discuss, and you may be able to discuss it all in one weekend. However, this conversation may take several visits.

Allow your parents time to process the information requested, and remind them that you are only trying to gather information to follow their wishes should a major medical event take place in their lives. If documents have not been drawn up, then encourage your parents to sit with an elder law attorney to draw up the necessary legal documents. Lastly, obtain information on your parents’ physicians, diagnoses, medications and health insurance.